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Objective The aim of this study was to assess the ability to smile following a hypoglossal–facial nerve transfer (N12–N7). Design This is a retrospective chart review. Setting National tertiary referral center for skull base pathology. Participants Seventeen patients. Main Outcome Measures The ability to smile following an N12–N7 transfer was assessed by five medical doctors on photographs of the whole face and frontal, orbital, and oral segments. The (segmented) photographs were scored for the symmetry, asymmetry, and correct or incorrect assessment of the affected side. Results Seventeen patients were analyzed by 5 assessors providing 85 assessments. The whole face at rest was judged symmetrical in 26% of the cases and mildly asymmetrical in 56%. Frontal, orbital, and oral segments were symmetrical in 63, 20, and 35%, respectively. The affected side was correctly identified in 76%. When smiling, the whole face was symmetrical in 6% and mildly asymmetric in 59%. The affected side was correctly identified in 94%. The frontal, orbital, and oral segments during smiling were symmetrical in 67, 15, and 6%, respectively. The affected side of the frontal, orbital, and buccal facial segments during smiling was correctly identified in 89, 89, and 96%, respectively. Interobserver variability with Fleiss' kappa analysis showed that the strength of the agreement during smile of the total face was good (0.771) Conclusion Following an N12–N7 transfer, a good facial symmetry at rest can be achieved. During smiling, almost all patients showed asymmetry of the face, which was predominantly determined by the orbital and oral segments. To improve the ability to smile after an N12–N7 transfer, additional procedures are needed. [ABSTRACT FROM AUTHOR]

Introduction: Classic heat stroke is a severe trauma which can lead to multi-organ dysfunctions and is associated with a high mortality. Case presentation: In this case report we present a 73-year-old patient with a classic heat stroke. His initial core body temperature was over 42 °C and he had a GCS of 3. Due to severe burn injuries the patient was transferred to a specialized burn center. The patient developed different organ failures and showed a prolonged course on the intensive care unit. Although the patient demonstrated different impaired organ systems, he recovered completely after receiving painstaking supportive therapy. Conclusions: This is a rare case of a patient who fully recovered after a heat stroke with a temperature over 42 °C and severe sequelae. [ABSTRACT FROM AUTHOR]

Background and Objectives: Cutaneous squamous cell carcinoma is the second most common skin cancer. There are many methods for the reconstruction of facial subunit defects after skin cancer excision. The face is vital to a person's life and should be reconstructed considering functional and aesthetic aspects. Despite a variety of flap types and techniques, it is still challenging to meet the various demands. The aim of this study was to compare free flaps for facial reconstruction after resection of cutaneous squamous cell carcinoma. Materials and Methods: This study included 14 patients from January 2021 to June 2023. Patients who underwent facial SCC resection and subsequent reconstruction using free flaps were analyzed retrospectively. Age, sex, and localization were recorded. Follow-ups ranged from 5 to 21 months, with an average of 13 months. Results: All free flaps survived well except one case of partial flap necrosis. In most patients, good to excellent functional and aesthetic results were obtained. The donor site healed uneventfully in all patients. Conclusions: Free flap reconstruction is an excellent choice in wide skin oncologic defects. In terms of texture, it also could be a good surgical method. The use of a fraxel laser can progressively facilitate improved color matching with the surrounding skin. [ABSTRACT FROM AUTHOR]

Abstract Introduction Classic heat stroke is a severe trauma which can lead to multi-organ dysfunctions and is associated with a high mortality. Case presentation In this case report we present a 73-year-old patient with a classic heat stroke. His initial core body temperature was over 42 °C and he had a GCS of 3. Due to severe burn injuries the patient was transferred to a specialized burn center. The patient developed different organ failures and showed a prolonged course on the intensive care unit. Although the patient demonstrated different impaired organ systems, he recovered completely after receiving painstaking supportive therapy. Conclusions This is a rare case of a patient who fully recovered after a heat stroke with a temperature over 42 °C and severe sequelae.

Reconstructing the face from the skull is important not only for forensic identification but also as a tool that can provide insight into the appearance of individuals from past populations. It requires a multidisciplinary approach that combines anthropological knowledge, advanced imaging methods, and artistic skills. In the present study, we demonstrate this process on the skull of an early medieval warrior from Croatia. The skeletal remains were prepared and scanned using multi-slice computed tomography (MSCT) and examined using standard anthropological and radiological methods. The analysis revealed that the remains belonged to a 35–45-year-old male individual who had suffered severe cranial trauma, probably causing his death. From MSCT images, we reconstructed a three-dimensional (3D) model of the skull, on which we digitally positioned cylinders demarking the soft tissue thickness and created the face with a realistic texture. A 3D model of the face was then optimized, printed, and used to produce a clay model. Sculpturing techniques added skin textures and facial features with scars and trauma manifestations. Finally, after constructing a plaster model, the model was painted and refined by adding fine details like eyes and hair, and it was prepared for presentation in the form of a sculpture.

Abstract In this paper, a method based on transfer learning is proposed to recover the three-dimensional shape of cultural relics faces from a single old photo. It can simultaneously reconstruct the three-dimensional facial structure and align the texture of the cultural relics with fewer training samples. The UV position map is used to represent the three-dimensional shape in space and act as the output of the network. A convolutional neural network is used to reconstruct the UV position map from a single 2D image. In the training process, the human face data is used for pre-training, and then a small amount of artifact data is used for fine-tuning. A deep learning model with strong generalization ability is trained with fewer artifact data, and a three-dimensional model of the cultural relic face can be reconstructed from a single old photograph. The methods can train more complex deep networks without a large amount of cultural relic data, and no over-fitting phenomenon occurs, which effectively solves the problem of fewer cultural relic samples. The method is verified by restoring a Chinese Terracotta Warrior with facial cracks and a Buddha with a broken nose. Other applications can be used in the fields such as texture recovery, facial feature extraction, and three-dimensional model estimation of the damaged cultural relics or sculptures in the photos.

Tessier number 10 cleft is one of the rarest facial clefts. Surgical treatment of this type of cleft is challenging due to the complexity of periorbital and temporal soft tissue deformities. A 23-year-old male patient presented with typical facial deformities of Tessier number 10 cleft. The surgical procedure involved using a free anterolateral thigh flap to reconstruct the eye socket, while the superficial temporal artery pedicle scalp flap was used to reconstruct the eyebrow deformity. The patient had no complications and 16 months after surgery, the patient had good aesthetic results. A hair-bearing scalp flap with a pedicle of the frontal branch of the superficial temporal artery combined with an anterolateral thigh-free flap can effectively resolve most soft tissue deformities of Tessier number 10 cleft and reconstruct the orbital socket in a single surgery. At the same time, it augments the soft tissue of the frontotemporal area and provides good aesthetic results. [ABSTRACT FROM AUTHOR]

Face transplantation (FT) has emerged as a critical intervention for patients with complex facial deformities unsuitable for conventional reconstructive methods. It aims to restore essential functions such as facial expression, mastication, and speech, while also improving psychosocial health. The procedure utilizes various surgical principles, addressing unique challenges of craniofacial complexity and diverse injury patterns. The integration of Computerized Surgical Planning (CSP) leverages computer-aided technologies to enhance preoperative strategy, intraoperative navigation, and postoperative assessment. CSP utilizes three-dimensional computed tomography, printing, angiography, and navigation systems, enabling surgeons to anticipate challenges and reduce intraoperative trial and error. Through four clinical cases, including a groundbreaking combined face and bilateral hand transplant, CSP's role in FT is highlighted by its ability to streamline operative processes and minimize surgical revisions. The adoption of CSP has led to fewer cadaveric rehearsals, heightened operative precision, and greater alignment with preoperative plans. Despite CSP's advancements, it remains complementary to, rather than a replacement for, clinical expertise. The demand for technological resources and multidisciplinary teamwork is high, but the improved surgical outcomes and patient quality of life affirm CSP's value in FT. The technology has become a staple in reconstructive surgery, signaling a step forward in the evolution of complex surgical interventions. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate existing staging recommendations for peri-implantitis and its applicability for auricular bone anchoring. In this cross-sectional study, 44 patients treated with 47 ear epitheses and 128 implants were analyzed over 191.6 months (mean). Peri-implant sulcus depth, sulcus fluid flow rate, and peri-implant skin reaction, as well as cleaning habits and patients' quality of life, were analyzed. Mixed effect linear and mixed effect ordered logistic regression models were used. Two of the 128 implants were lost (1.6 %). A total of 14.5 % of all patients presented light erythemas, 19.4 % showed stage 2, 4.8 % stage 3, and 12.9 % an acute infection according to Holgers. A correlation between skin reaction and sulcus fluid flow rate was observed, when grouping patients with acute signs of inflammation. Concerning patient satisfaction, 58.1 % of the patients were highly satisfied with their epitheses, 39.5 % very satisfied, and one patient was just satisfied. Younger age correlated with lower satisfaction rates. Implant-retained auricular epitheses are a safe, highly sufficient and satisfying way of extending ear reconstruction. Sulcus depth and skin reaction are quick and valuable assessment tools in auricular implants, but skin reaction alone was clinically insufficient to predict peri-implant pocket inflammation. [ABSTRACT FROM AUTHOR]

Background: V-Y advancement flap (VYAF) is a commonly used flap for facial reconstruction, but it is not popular in Asian society with limited aesthetic outcome evaluation. Objective: To demonstrate our experience of facial VYAF with the quantitative aesthetic outcome assessment. Methods and Materials: From January 2013 to December 2022, patients who underwent facial VYAF reconstruction were reviewed. Postoperative photographs were collected and independently graded by three plastic surgeons, three nurses, and six non-medical personnel using Manchester scar scale (MSS). The representative preoperative images were selected for surgeons' reconstruction preferences survey. Results: Forty-eight patients (27 females and 21 males), with a mean age of 66.8 (23–97) years, were included in this study. All flaps survived with no flap necrosis. Only six patients (12.5%) developed minor postoperative complications, and they were treated conservatively and resolved uneventfully. The total MSS score was 7.8 ± 1.9 (scale of 4 [best scar] to 24 [worst scar]) and the overall scar VAS rating was 1.9 ± 1.1 (0 [best scar] to 10 [worst scar]), indicating satisfactory postoperative scar condition. From the survey of 22 plastic surgeons and 11 scenarios, VYAF was rarely chosen among other local flaps which only accounted for 8.7%. Conclusion: VYAF is an easy and safe method for facial reconstruction with low morbidity, but its usefulness is underappreciated. With a proper design and cautious dissection, we believe that good aesthetic and functional outcomes can be achieved with VYAF. Level of Evidence IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. [ABSTRACT FROM AUTHOR]

Aim of the Study: To describe methods and outcomes of using the forehead flap for reconstruction in patients with diverse facial defects. Patients and Methods: A retrospective analysis was conducted on patients who underwent forehead flap surgery for facial defect reconstruction at our centre between January 2022 and December 2023. This comprised of 7 individuals with various aetiologies. Patient demographics, preoperative assessments, surgical details, postoperative complications, and long-term outcomes were studied. Results: Of the 7 patients included in the study, 4 had post traumatic defects, 3 had defects following surgical resection. Forehead flap had been used for reconstruction of scalp, eyelids, nose, palate, lips and floor of mouth. Surgical outcomes were mostly successful with good patient satisfaction, although some patients had peri-operative complications due to co-existing morbidities. Conclusion: Forehead flaps are versatile, effective, reliable with tolerable morbidity; and can hence be used for addressing a variety of craniofacial defects [ABSTRACT FROM AUTHOR]

In this paper, a method based on transfer learning is proposed to recover the three-dimensional shape of cultural relics faces from a single old photo. It can simultaneously reconstruct the three-dimensional facial structure and align the texture of the cultural relics with fewer training samples. The UV position map is used to represent the three-dimensional shape in space and act as the output of the network. A convolutional neural network is used to reconstruct the UV position map from a single 2D image. In the training process, the human face data is used for pre-training, and then a small amount of artifact data is used for fine-tuning. A deep learning model with strong generalization ability is trained with fewer artifact data, and a three-dimensional model of the cultural relic face can be reconstructed from a single old photograph. The methods can train more complex deep networks without a large amount of cultural relic data, and no over-fitting phenomenon occurs, which effectively solves the problem of fewer cultural relic samples. The method is verified by restoring a Chinese Terracotta Warrior with facial cracks and a Buddha with a broken nose. Other applications can be used in the fields such as texture recovery, facial feature extraction, and three-dimensional model estimation of the damaged cultural relics or sculptures in the photos. [ABSTRACT FROM AUTHOR]

Reconstructing the face from the skull is important not only for forensic identification but also as a tool that can provide insight into the appearance of individuals from past populations. It requires a multidisciplinary approach that combines anthropological knowledge, advanced imaging methods, and artistic skills. In the present study, we demonstrate this process on the skull of an early medieval warrior from Croatia. The skeletal remains were prepared and scanned using multi-slice computed tomography (MSCT) and examined using standard anthropological and radiological methods. The analysis revealed that the remains belonged to a 35–45-year-old male individual who had suffered severe cranial trauma, probably causing his death. From MSCT images, we reconstructed a three-dimensional (3D) model of the skull, on which we digitally positioned cylinders demarking the soft tissue thickness and created the face with a realistic texture. A 3D model of the face was then optimized, printed, and used to produce a clay model. Sculpturing techniques added skin textures and facial features with scars and trauma manifestations. Finally, after constructing a plaster model, the model was painted and refined by adding fine details like eyes and hair, and it was prepared for presentation in the form of a sculpture. [ABSTRACT FROM AUTHOR]

Throughout history, progress in medicine has been intrinsically linked to the dynamics of warfare, driving innovations and transforming medical practices for the civilian population. This paper examines how World War I, characterized by the unprecedentedly large-scale utilization of trench warfare and modern mechanized weapons, catalyzed the development of medical technologies and techniques, fundamentally transforming medical practices thereafter. Key areas of medical progress discussed in this paper include facial reconstruction, vaccination for infectious diseases, mobile medical imaging, and blood preservation and transfusion, as well as their immediate and far-reaching impacts on society thereafter. Drawing upon a broad range of historical evidence such as first-hand account books, oral accounts, museum resources, and primary documents in French and English, this paper not only provides a comprehensive review of the major innovations in medical technology during World War I but also reveals the diverse personal perspectives that soldiers developed in response to the implementation of novel medical technology in that time, revealing the complex challenges associated with rapid medical and technological advancements. Overall, this paper explores the revolutionary impacts of important medical development during World War I and offers new insights into the interplay between wartime devastation and medical progress. [ABSTRACT FROM AUTHOR]

The face is one of the most representative structures of human anatomy and ballistic trauma has a high destructive power, therefore, gunshot hot wound in the facial region turns out to be highly complex. We describe the protocol for the management in three stages of a facial trauma from a multiple-load firearm in a young patient, and we highlight the value of conventional and traditional techniques for its resolution in a situation of limited economic and hospital resources. [ABSTRACT FROM AUTHOR]

Severe craniofacial fractures may present different needs in treating intracranial lesions over facial injuries. This paper examines the results of our strategy, consisting of a single-stage combined neurosurgical-maxillofacial treatment. A retrospective review was conducted of 33 consecutive patients with complex fractures of the anterior cranial fossa and facial skeleton, who required elective surgery for craniofacial reconstruction. Patients who required emergency surgery for intracranial clots or penetrating wounds were excluded. In all cases, all or almost all the anterior skull-base was injured with compound fractures of the frontal sinus, the orbital roofs, the lamina cribrosa, and the planum sphenoidale. In all cases, the prioritization of treatment was carefully discussed, and surgical timing and strategy were agreed. There was 1 dead. Olfactory injuries were always found intraoperatively. There were no mucoceles, CSF-leak recurrences, cranial infections, or neurologic worsening. The functional and neurologic results were highly satisfactory. The one-stage surgical treatment of complex craniofacial fractures has numerous advantages, including the possibility of reducing facial fractures without the risk of CSF leaks. It also eliminates the need for repeated procedures in fragile patients, and the need to dismantle the facial reconstruction if the skull base repair is performed later. The main issue is the surgical timing, considering that the maxillofacial surgeon usually favors early facial repair, whereas the neurosurgeon generally prefers delayed manipulation of the contused frontal lobes. A timeframe of 10–14 days after trauma may be a good compromise for safe procedures with excellent neurologic and functional outcomes. [ABSTRACT FROM AUTHOR]

Facial implantology (FI) is a growing field in facial surgery that focuses on harmonizing and balancing facial features. Despite its increasing popularity, larger-scale studies on FI outcomes and risks are scarce. The ACS-NSQIP (2008–2021) was queried to identify patients who underwent combined/isolated alloplastic FI surgery of the malar/mandibular region. Based on CPT codes (21125; 21270), procedures were subdivided into combined or isolated FI surgery of the malar or the mandibular region. The study population included 84 patients, of which n = 19 (23%), n = 10 (12%), n = 33 (39%), and n = 22 (26%) underwent combined malar, isolated malar, combined mandibular, and isolated mandibular FI surgery, respectively. Isolated malar (total n = 10) and mandibular FI surgery (total n = 22) patients had relatively high comorbidity rates with up to n = 6 (60%) active smokers and n = 9 (41%) with hypertension, respectively. Combined malar (n = 19) and mandibular FI surgeries (n = 33) had the highest complication rates with n = 3 (16%) and n = 5 (15%) patients experiencing any complications. For both isolated malar and mandibular FI procedures, n = 1 (10% and 4.5%) patient reported any complications. In this study, we accessed the ACS-NSQIP database and found alloplastic augmentation for zygoma and mandible to be safe. Patients who underwent combined procedures and mandibular augmentation were more likely to show complications or require inpatient stay. Most alloplastic augmentations of mandible or zygoma were combined with other procedures (62%) which suggests that alloplastic facial implants (in the academic setting) are often used as an adjunct in the treatment of complex craniofacial disorders. [ABSTRACT FROM AUTHOR]

Large soft tissue defects of the face often require free flap-based reconstruction. To avoid a conspicuous patch-like appearance, choosing flaps with a color similar to that of the adjacent facial skin is crucial. This study aimed to identify the flap types that show the best color match via objective color evaluation. Patients who underwent free flap-based facial reconstruction between 2013 and 2023 were retrospectively reviewed. Based on standardized photographs, average color samples of the flap skin paddle and adjacent skin were obtained. The color differences were compared by flap type at two different time points, early (within 1–3 months, post-operative) and late (after 1 year, post-operative), using the delta E value. Fifty-eight free flaps were analyzed, including 22 thoracodorsal artery perforator (TDAP) flaps, 17 anterolateral thigh (ALT) flaps, nine superficial circumflex iliac artery perforator (SCIP) flaps, and eight radial forearm (RF) flaps. In the analysis of early outcomes, the RF flaps showed the least color difference, followed by the SCIP and TDAP flaps, and the ALT flaps showed the greatest difference, with the differences being significant. Most cases showed generally improved color matching over time. Time-dependent changes were significant in the ALT and TDAP flap groups. In the analysis of late outcomes, all flap types showed delta E values less than 10, with the RF flaps showing the least color difference, followed by the SCIP flap. The four workhorse flaps provided acceptable outcomes with long-term improvements. The RF flaps provided the best color matching in the long run. [ABSTRACT FROM AUTHOR]

Abstract The use of digital technologies in archaeological research has become considerably more widespread in recent years. While the earliest records of the use of electronic data in archaeology date from the 1950 and 1960s, the field has kept growing with the increasing interest in digital tools such as digital photography, three-dimensional imaging, GIS, virtual and artificial reality applications, CAD and facial reconstruction. Such digitization practices are used frequently for documenting, record keeping, and preserving and representing the data recovered from archaeological contexts, and are linked to other fields, such as cultural heritage studies and museology. Facial reconstruction is used to recreate the faces of individual from the past using their skeletal remains. It has been practiced for different reasons in the fields of forensics, anthropology, and archaeology. This study focuses on the facial reconstruction of a skull unearthed from Juliopolis. The reason for choosing this skull in this study is that it is the first and only known deformed skull dated to the Roman period in Anatolia. For the facial reconstruction application, authors created a 3D modelling of the skull by photogrammetry. Then, the missing parts of the skull are completed using the virtual donor library. The results are presented in different forms, as grayscale, in colour with eyes closed or open. Also, the type of deformation is demonstrated in the skull. This study adopts a digital process and is more strongly linked to data interpolation related to the external surface of the face. The prominent advantage of the methodology is being strongly supported by information obtained from computed tomography (CT) scans of living individuals, leaving a little room for the artistic issue in relation to the basic aspect resulting from the interpolation of data. The benefit of facial reconstruction is especially important since it is a way of preserving and presenting archaeological and anthropological data.

Background and Objectives: Cutaneous squamous cell carcinoma is the second most common skin cancer. There are many methods for the reconstruction of facial subunit defects after skin cancer excision. The face is vital to a person’s life and should be reconstructed considering functional and aesthetic aspects. Despite a variety of flap types and techniques, it is still challenging to meet the various demands. The aim of this study was to compare free flaps for facial reconstruction after resection of cutaneous squamous cell carcinoma. Materials and Methods: This study included 14 patients from January 2021 to June 2023. Patients who underwent facial SCC resection and subsequent reconstruction using free flaps were analyzed retrospectively. Age, sex, and localization were recorded. Follow-ups ranged from 5 to 21 months, with an average of 13 months. Results: All free flaps survived well except one case of partial flap necrosis. In most patients, good to excellent functional and aesthetic results were obtained. The donor site healed uneventfully in all patients. Conclusions: Free flap reconstruction is an excellent choice in wide skin oncologic defects. In terms of texture, it also could be a good surgical method. The use of a fraxel laser can progressively facilitate improved color matching with the surrounding skin.

Although permanent fillers have been introduced in order to get long-lasting results, many studies have shown numerous severe and disfiguring complications. Nonsurgical procedures may mitigate those adverse events but the only way to remove the filler previously injected is represented by surgical excision. We present a pathway of facial surgical accesses to be performed achieving two goals: permanent filler removal and restore facial aesthetic balance. The proposed surgical accesses are already standardized in aesthetic surgical practice in order to avoid direct excision and unpleasant facial scar. A total of 231 patients underwent surgery for permanent filler removal and aesthetic restoration of the involved facial area, represented by forehead, glabella, nose, cheeks, eyelids, chin, jawline, and lips. Magnetic resonance evaluation was performed with the exception of lip patients who were evaluated with ultrasound. Postoperative follow-up was 12 months to 6 years. Subjective and objective methods were used for outcome evaluation according to the FACE-Q questionnaire. Functional and aesthetic correction was scored using the patient-graded Global Aesthetic Improvement Scale (GAIS), overall patient satisfaction was assessed by a five-point scale questionnaire. Functional and aesthetic restoration was globally recognized as improved according to the GAIS. Patients reported high levels of satisfaction assessed by a five-point scale questionnaire. A very good satisfaction level was registered in both subjective and objective judgment scores. To the best of our knowledge, we present the largest case series regarding surgical removal of permanent facial fillers. A proper preoperative evaluation, filler removal followed by restorative facial aesthetic surgery technique is paramount to approach challenging cases. [ABSTRACT FROM AUTHOR]

Background: Lower lip reconstruction is crucial to restore oral integrity post-cancer excision. A perfect balance between form and function should be achieved. With an aging demographic, adapting surgical methods to meet the unique needs of the elderly becomes imperative. Our study aims to introduce a specialized algorithm for lower lip reconstruction; it was tailored to geriatric patients and emphasized the use of "simpler flaps". Additionally, "Pearls and Pitfalls" were provided for surgeons approaching lower lip reconstruction. Methods: Between January 2018 and June 2021, a retrospective study was carried out. Data collection included patient demographics, defect attributes, reconstructive approaches, flap viability assessment, wound healing, and complications. The follow-up was carried out for a period of a minimum of 6 months. Results: Among 78 patients, squamous cell carcinoma predominated with a mean defect area of 3308 cm2. Postoperative complications were recorded in two patients. All patients reported sensory restoration and overall satisfaction at the 6-month follow-up; secondary procedures were not necessary. Conclusion: Our reconstructive algorithm, focused on elderly patients, prioritizes less invasive reconstructive techniques and introduces innovative modifications to the established methods to achieve both aesthetic and functional outcomes with a low complication rate. In patients undergoing lower lip reconstruction, the subjective microstomia was found to be less relevant than the objective microstomia. [ABSTRACT FROM AUTHOR]

The use of digital technologies in archaeological research has become considerably more widespread in recent years. While the earliest records of the use of electronic data in archaeology date from the 1950 and 1960s, the field has kept growing with the increasing interest in digital tools such as digital photography, three-dimensional imaging, GIS, virtual and artificial reality applications, CAD and facial reconstruction. Such digitization practices are used frequently for documenting, record keeping, and preserving and representing the data recovered from archaeological contexts, and are linked to other fields, such as cultural heritage studies and museology. Facial reconstruction is used to recreate the faces of individual from the past using their skeletal remains. It has been practiced for different reasons in the fields of forensics, anthropology, and archaeology. This study focuses on the facial reconstruction of a skull unearthed from Juliopolis. The reason for choosing this skull in this study is that it is the first and only known deformed skull dated to the Roman period in Anatolia. For the facial reconstruction application, authors created a 3D modelling of the skull by photogrammetry. Then, the missing parts of the skull are completed using the virtual donor library. The results are presented in different forms, as grayscale, in colour with eyes closed or open. Also, the type of deformation is demonstrated in the skull. This study adopts a digital process and is more strongly linked to data interpolation related to the external surface of the face. The prominent advantage of the methodology is being strongly supported by information obtained from computed tomography (CT) scans of living individuals, leaving a little room for the artistic issue in relation to the basic aspect resulting from the interpolation of data. The benefit of facial reconstruction is especially important since it is a way of preserving and presenting archaeological and anthropological data. [ABSTRACT FROM AUTHOR]

Background: The flap repair method is the most frequently used technique for covering congenital or acquired defects that disrupt the integrity of body. We aimed to investigate maximum size of reliable lateral thoracic artery-based faciocutaneous (LTAF) flap and to determine its usage in which part of the body defects in rabbits. Methods: In this study, 10 white New Zealand rabbits were used. The study had two parts. In part 1, a total of 5 rabbits were used, two of them in barium microangiography and three of them to investigate flap viability. Flap survival was investigated clinically and fluorescent dye. In the second part, potential target points for the flap were determined on 5 rabbits. Results: In the first part, average 8.1 cm wide and average 6.8 cm length of LTAF flaps were harvested and flaps resutured. Neither partial nor total flap necrosis was observed in all animals. In the second part, average 7.7 cm wide and average 6.5 cm length of LTAF flaps were harvested and transferred target tissue. The flaps that covered on created defects on the ear, face, neck, feet, and contralateral back of the rabbits were followed for 6 weeks. The partial loss of tissue in the neck and back were 25% and10%, respectively. Conclusions: LTAF flap is an ideal experimental model that can be used in large defects, have a long pedicle, wide arc of rotation, and being as thin as possible to configurate. Level of evidence: Not gradable. [ABSTRACT FROM AUTHOR]

Full-thickness lower eyelid defects after Mohs micrographic surgery are frequently referred out to oculoplastic surgery for reconstruction. Reconstructive options include wedge closure with or without canthotomy/cantholysis and tarsoconjunctival sliding flaps. Defects > 50% of the eyelid margin have traditionally required the two-stage Hughes flap, leaving the patient with monocular vision for 3–6 weeks until pedicle division. To demonstrate single-stage periosteal flaps performed by dermatologic surgeons can result in safe, functional, and cosmetically acceptable repairs for large full thickness eyelid defects, an institutional review board-approved retrospective study of repairs performed by two dermatologic surgeons between January 2017 and July 2021 at the University of Minnesota. Patient demographics, operative notes, and follow-up notes were reviewed. Defect and follow-up photographs were scored using a visual analogue scale to assess aesthetic results. Ten cases were included in the analysis. Six patients were male and the average age was 62 years old. 8/10 were basal cell carcinoma and 2/10 were melanoma. The mean defect was 9.5 cm2, with a range of 1–24 cm2. The median cosmetic score was 85.8 ± 10.7. There were no serious complications reported. Mohs micrographic surgeons can safely and successfully reconstruct large, full thickness eyelid defects by periosteal flap. [ABSTRACT FROM AUTHOR]

This article describes the many anomalies within and outside the head and neck of hemifacial microsomia (HFM).

Purpose: Acquired defects of the central face pose significant challenges in achieving acceptable cosmetic and functional outcomes. The site, size, and depth of tissue loss often render local tissues inadequate for the repair of major nasal defects. In this article, we aim to demonstrate the efficacy of radial forearm-free flaps as an ideal choice for various central facial unit reconstructions. Methods: This study encompassed patients treated between 2020 and 2022 who underwent facial reconstruction using radial forearm flaps. These flaps were employed in eleven patients with defects involving the lower lid, nose, upper lip, and lower lip. Additionally, we used osteocutaneous flaps in one patient to reconstruct a right nasal bone defect. In three patients requiring medial and lateral canthal tendon reconstruction in one case and oral sphincter reconstruction in two cases, the palmaris longus tendon was included with the flap. Results: In the majority of cases, we achieved good to excellent aesthetic and functional results. Notably, there were no instances of flap failure or partial necrosis in this series. All patients experienced uneventful healing at the donor site. Conclusions: The radial forearm-free flap stands as an ideal and reliable method for reconstructing various facial defects. It offers efficient and thin-conforming skin coverage. [ABSTRACT FROM AUTHOR]

Prediction methods for regions not lined by facial bones are important elements of forensic anthropology, including forensic facial approximation. The alar region can be predicted by measuring the distances from the piriform margin and multiples of the piriform width. However, studies investigating this region are limited, and some only focus on one side of the alar region. Hence, we aimed to measure the bony points/landmarks to predict the alar region. Post-mortem computed tomography images of the samples from 180 Japanese individuals were obtained and analyzed. The images were processed using Osirix (Pixmeo). The coordinates recorded from all samples were calculated, and the values obtained were stratified by sex, laterality, age, body mass index, and cephalic index. The distances between the alar and the five piriform points were measured. The mean, standard deviation, and confidence interval of all samples were calculated, and the sex-related differences were determined. We evaluated the correlation between alares and other boney landmarks and points. Our findings were compared with those of previous studies. We observed significant sex differences (p < 0.01) and asymmetry (p < 0.01) in laterality in this region; hence, asymmetry was assessed based on these results. Compared with the results of previous studies, the obtained measurements were larger than those of a previous Asian study, suggesting that laterality may influence the accuracy of prediction methods for regions not lined by hard tissues. [ABSTRACT FROM AUTHOR]

Background: INTERPLAST, Inc. was founded in 1969 by plastic surgeons in Stanford, CA, to create a financial basis through donations to operate foreign patients at Stanford or send surgical teams to developing countries. With the same financial effort, 50 to 100 times more patients can be operated on locally than in a hospital at home. Stanford's example was appealing to many plastic surgeons worldwide, who founded similar INTERPLAST NGOs in their own countries. Methods: A literature review revealed worldwide humanitarian actions of INTERPLAST teams, whose annual effectiveness is comparable to the operation numbers of large plastic surgery departments. Six patients with complex facial deformities requiring multiple surgical interventions were selected for temporary stay and operations in Germany. Results: Repeated missions at the same hospitals with training of local surgeons have increased significantly compared to earlier "parachute missions." Microsurgical procedures for free flaps with magnifying glasses are now possible for the experienced even in hospitals in developing countries. The most efficient medical aid in the future will be the expansion and establishment of departments or hospitals in developing countries supported or maintained by partner hospitals in our home country. Conclusions: Operations of humanitarian plastic surgeons in developing countries are becoming increasingly difficult. Local health authorities require temporary surgical permits, customs offices try to clear surgical material and look at expiration dates of medicines, and pandemics complicate planning of INTERPLAST missions. It therefore seems increasingly necessary to go as single teacher, training engaged local surgeons and assisting operations. The alternative is inviting local surgeons to Western hospitals and introducing them to the basic skills of plastic surgery and empathy with the poor. However, the lack of recognition of medical degrees from all developing countries remains a problem for their training in Europe. Level of evidence: Level V, risk/prognostic [ABSTRACT FROM AUTHOR]

Introduction: Basal-cell carcinoma is currently the most frequent type of skin cancer, its main risk factor being exposure to ultraviolet radiation. Treatment consists of surgical resection, according to recurrence risk. Post-resection facial reconstruction should be faced according to the aesthetic unit of the face, which will determine the surgical technique. Material and Method: The following clinical case presents the resection of a morpheiform nodular basal-cell carcinoma located on the cheek and nasal wing, and subsequent reconstruction using a Mustardé flap, with successful results. Results: Favorable evolution with complete resection of the tumor lesion and postoperative vitality of the flap. The patient presented a slight nasal deviation that resolved with scar massage. A nasal wing plasty can be considered in the future. Conclusion: We present a facial basal-cell carcinoma clinical case that was safely and effectively treated with a Mustardé flap. [ABSTRACT FROM AUTHOR]

Since the early nineties, the Anthropos Institute of the Moravian Museum in Brno has been surveying the prehistoric mining of Jurassic chert in the region of the Krumlovský les (Krumlov Forest) in southern Moravia. This research follows the recent identification of this area as one of the largest mining areas in prehistoric Europe, both due to the extent of its distribution, and its excellent state of preservation. In one of the hundreds of mining shafts, dated to Late Lengyel Culture, human remains were found, which were subjected to comprehensive research and the anthropological reconstructions of which are presented in this article. Today, reconstruction methods are experiencing a worldwide renaissance and are being widely used in historical anthropology. [ABSTRACT FROM AUTHOR]

Background: Divided zygoma (DZ) is an important structure in the midfacial region. The anatomy of DZ is poorly researched, but knowledge about this entity could be useful during posttraumatic facial reconstructions. The aim of this study was to estimate the prevalence and anatomy of DZ in different regions around the world. Therefore, the authors performed a meta-analysis, including all studies that report extractable data on the DZ. Materials and methods: The main online medical databases such as PubMed, EBSCO, ScienceDirect, Web of Science, SciELO, BIOSIS, Current Content Connect, Korean Journal Database and Russian Citation Index, were utilised to gather all studies on anatomical characteristics, prevalence, symmetry, and a number of divisions of zygomatic bone. Results: A total of 20 studies were included in this meta-analysis. Data were grouped and analysed in five categories: (1) prevalence of DZ bone, (2) prevalence of DZ skulls, (3) gender prevalence of DZ with sides, (4) divisions of zygomatic bone, (5) symmetry of DZ. Conclusions: In conclusion, the authors of the present study believe that this study can be considered an up-to-date meta-analysis regarding the prevalence, divisions, and symmetricity of the DZ. The data provided by the present study may be useful information for physicians in recognizing the DZ of the fracture and may be important information during zygomatic bone osteotomy. Detailed anatomical knowledge of the midfacial region can prevent surgical complications when operating in this area. [ABSTRACT FROM AUTHOR]

This review provides a comprehensive presentation of the evidence available in facial reconstruction post-Mohs micrographic surgery. Given the large diversity in post-Mohs reconstruction, there are limited guidelines in the management of defects. The aim of the present work is to provide a review of the best evidence as it pertains to several considerations in facial reconstruction. Data suggests that Mohs micrographic surgery and many reconstructive procedures can be performed as outpatient procedures under local anesthesia, with narcotic pain medication only given in certain patient populations following a minority of reconstructive procedures. Perioperative and topical antibiotics are generally not indicated. Aspirin and warfarin can generally be continued for most reconstructive procedures, but clopidogrel and novel anticoagulants may predispose to increased bleeding complications. Delayed reconstruction appears to be safe, although data are discordant on this topic. No specific wound closure technique or suture choice appears to be consistently superior. Given the lack of robust comparative studies, consistent methodology, and variable defect sizes/locations, no robust evidence-based guidelines can be generated for reconstruction techniques of facial subsites. [ABSTRACT FROM AUTHOR]

Background: Ameloblastoma in 66% of the cases harbor a somatic mutation of the "mitogen-activated protein kinase" signaling pathway (BRAF V600E). In V600E mutations, BRAF is in the permanent "on" state and relays the growth-promoting signals independently of the EGFR pathway. Therefore, mutant BRAF represents a target for handful of new drugs. Methods: We conducted a literature search, with the search terms "Vemurafenib, Dabrafenib, Ameloblastoma, and BRAF." These included seven case reports with nine patients who underwent monotherapy with Dabrafenib or Vemurafenib or combination therapy with Dabrafenib and Trametinib. Results: The patients age ranges from 10 years up to 86 years. The distribution of women and men is 4:5. Patients with an initial diagnosis of ameloblastoma, as well as recurrences or metastasized ameloblastoma were treated. Indications cover neoadjuvant therapy up to the use in metastasized patients in an irresectable state. Results ranging from "only" tumor size reduction to restitutio ad integrum. Conclusion: We see the use of BRAF Inhibitors to reduce tumor size with consecutive surgical treatment as a reasonable option for therapy. However, we are aware that at present the data are based only on case reports with the longest follow-up of just 38 months. We encourage further clinical trials in the use of BRAF Inhibitors for selecting ameloblastoma patients in a multi-center setting. [ABSTRACT FROM AUTHOR]

Traditionally, research on three-dimensional (3D) facial reconstruction has focused heavily on methods that use 3D Morphable Models (3DMMs) based on principal component analysis (PCA). Because such methods are linear, they are robust to external noise. The PCA method has limitations when restoring faces that deviate from the training data distribution, particularly when recovering fine details. By contrast, restoration methods utilizing Graph Convolution Networks (GCN) offer the advantages of non-linearity and direct regression of vertex coordinates and colors. However, GCN-based approaches can be prone to overfitting, making them less stable. This study presents a face restoration approach that aims to regress the vertex coordinates and colors of a 3D face model directly from a single wilds 2D facial image. This method demonstrates greater stability and higher accuracy compared to conventional techniques. In addition, Graph Attention Networks (GAT) enhance the restoration performance while separating the networks responsible for facial shape and color, reducing noise caused by interference between different data attributes. Through experiments, we demonstrate the most optimized network structures and training methods and demonstrate improved performance compared to existing approaches.

Introduction: In the subcontinent of India as well as for the other nations, the most usual cancer that affects the oral cavity the “squamous cell carcinoma”. The main side effects of the intervention of the SCC are the large defect and disfigurement. This study sought to investigate the various interventions of the SCC in a designated cancer institute. Material and Methods: A retrospective clinical study of the records was done between 2000–2020 years. The operated cases were analysed for various patient demographics as well as the site of the lesion and number distributions. The change in the techniques and the preference flaps over the periods was noted, and the values were compared for every 5 years. Results: A1001 patients were treated between the intended periods. Though there were larger number of men, the variation was not significant. Common sites were floor of the mouth (FOM) and tongue. The common interventions were primary closure, soft tissue free flaps and bone flaps. The shift was seen towards the free flaps. Conclusion: The Free flaps were the common applications in the constructions. Bone free flaps overtook the other procedures that were commonly applied. The quality of life and the aesthetics are seen to be better with the free flaps.